Hemostat tonsillotome



Sept. 30, 1941.

v. Tam-'UER' l HEMOSTAT TONSILLOTOME Filed Nov. 4, 1940 'I @j [M F1a i TTORNEY Patented Sept. 30, 1941 Victor Trottier, Windsor, Ontario, Canada Application November 4, 1940, Serial No. 364,281

In Canada June 3, 1940 (Cl. 12S- 309) 9 Claims.

` My invention relates to the type of surgical instruments called tonsillotomes, tonsil enucleators, or tonsil snares. The primary purpose of the instrument is for the removal of faucial tonsil. It is also useful for the removal of other inaccessible parts. An object and feature of my invention is the employment with the tonsillotozne of a gripping pincer having a hemostatic function, this Abeing designed to lie under the fenestra of the instrument to thoroughly crush the tissues, and being suiiiciently rugged in construction to accomplish the desired hemostasis.

Another feature of my invention which is illustrative of its simplicity of construction and operation is, the making of the hemostat blades integral with the fixing blades so that, as such blades are used to loosen and disengage the embedded tissues and properly secure them for operative purposes, the hemostat fixing blades will function to crush the tissues held adjacent thereto.

The present methods of performing tonsillectomy yare the sluder method and the dissection method. The instruments used in the sluder method have a large handle which operates from across the oral cavity `thus limiting the view of the field of operation. The sluder method can only be performed under a general anaesthesia with considerable resultant shock and `hazard and necessitating the exercise of a high degree of operating skill. The dissection method embodies a long operation requiring a suction machine to clear the blood from the field of operation and also causing much tissue traumatism.

The need has been felt of a simple device for operating purposes, a snare in the nature of a tonsillotome and a hemostat to prevent or lessen bleeding and trauma.

The common instruments heretofore employed for tonsillectomy have a comparatively large gripping handle at right angles to the operating surface of the instruments, and a frame within which the hemostat and cutting blades operate. 'Ihe present invention is designed to simplify construction embodying the Vfeatures of a tonsillotome and a hemostat in one instrument of small dimensions.

Furthermore the common instruments have only one hemostatic blade operation within a frame, crushing the tonsil against the frame toward the posterior pillar of the tonsil and having an anterior posterior action. The present invention has on the contrary two hermostatic blades, one blade operating downward from Ialcove the tonsil and one blade operating upward from below the tonsil along the Aborder of the anterior pillar and being pressed together on the base of the tonsil.

Instruments heretofore used for tonsillectomy have the hemostat blade anterior to the cutting blade and the operation is performed from yacross the oral cavity. The tonsil is manipulated through the aperture in the instrument requiring considerable skill dependent largely upon the touch for its accuracy as the view is limited. The present invention has the cutting blade anterior to the hemostatic blades and the operation is performed from without the oral cavity allowing full View of the field of operation at all times. In the present invention the function of the hemostatic blades is to close the base of the tonsil next to the pharynx under the tonsillotome blade. The function of the tonsillotome blade is to severthe tonsil along the hemostatic blades while the blades are clamp-ed and so remain until all danger of hemorrhage is over. v

My invention is illustrated in connection `with the accompanying drawing in which: s

Fig. 1 is a plan view with the hemostatic forceps open and the tonsillotome extended so as to facilitate the insertion of the tonsil throughthe opening or fenestra in the head of the tonsillotome.

Fig, 2 is the same yas Figure 1 with the hemostatic forceps clamped down on the tonsil.

Figure 3 is the same as the previous Figure 2, with the tonsillotome drawn back to sever the tonsil.

Figure 4 is a transverse longitudinal view in a vertical position of the assembled instrument.

Figure 5 is a cro-ss-section of the head of the tonsillotome showing the cutting edge.

Figure 6 is a plan View of the fenestra head with thehemostatic forceps open `and the tonsil1o tome extended, shown in reverse View to that 4shown in Figure 1.

Like figures of reference indicate like iigures in the drawing.

Referring to the drawing, l is the large grip at the butt extremity of the hemostatic forceps used to open and close the hemostatic blades. 2 are the locks of the hemostatic forceps which lock the homostats to keep the top end of the hemostatic blades 3 clamped together. 4 is the apex of the hemostatic forceps showing the stabilizing lugs, which overlap and stabilize the head of the tonsillotome 8` 5 are the dentated edges on the inside of the hemostatic blades, which grip or crush the tissue at the base of the tonsil and prevent bleeding after the tonsil has been forced upward through the fenestrated head of the tonsillotome 8. 6 is the curved tail extremity of the tonsillotome so as to facilitate application of force up and down on the tonsillotome as the tonsils are severed. I is the body blade of the tonsillotome. 8 is the fenestrated oval head of the tonsillotome through which the tonsil has been forced before cutting. 9 is the cutting edge on the inside of the fenestra in the head of the tonsillotomewhich severs the tonsil when the blade 'I is drawn back. Il] is the encasing lock around the assembled joint which holds the component parts together by means of screw II through appropriate openings in the hemostatic blades 3. I2 is a pin adapted to centre the tonsillotome within the hemostatic blades. I3 are lugs to prevent the hemostatic blades from spreading too wide. I4 is a pin to lock the blades when in extended position.

In operation the hemostatic blades 3 are used to locate the tonsil or other tissue to be removed and to force the same upward through the fenestrated head 3 of the tonsillotome blade 'I. rIhe hemostatic blades 3 are then pressed together by compressing the gripping handles I in a scissorlike manner, the pressure exerted causing the required hemostatic pressure on the tonsils. The blades 3 are then locked by means of the locking means 2 and the tonsillotome blade 'I is pulled ydownwardly by means of pressure on the handle 6. The sharp, bevelled edge 9 of the fenestrated head 8 dissects the tonsil, the desired hemostasis being secured by the blades 3 which grip the tonsil 'by means of the dentated edges 5.

While I have shown and described in this application one embodiment which my invention may assume in practice, it will be understood that such disclosure is merely for the purpose of illustration and description, and that .various other forms may be devised within the scope of 4Q ing engagement with` said jaws during motion of said head thereover.

3. In a tonsillotome as claimed in claim 1 means for maintaining said cutting edge in sliding engagement with said jaws during motion of said head thereover comprising a horn on each hemostat jaw extending rearwardly from the free extremity thereof and closely overlying a part of said head.

4. In a tonsillotome, a pair of crossed clamping members, a pin on which said members are fulcrumed, hemostat jaws on one pair of extremities of said members, handle parts at the opposite extremities of said members, a sleeve mounted longitudinally of the instrument, a slide mounted on said members for motion longitudinally of the instrument, a head on said slide normally overlying said hemosat jaws, and a cutting edge on said head.

5. In a tonsillotome as claimed in claim 4, means for maintaining said cutting edge in sliding engagement with said jaws during motion of said head thereover.

6. In a tonsillotome as claimed in claim 4, means for maintaining said cutting edge in sliding engagement with said jaws during motion of said head thereover comprising a horn on each hemostat jaw extending rearwardly from the free extremity thereof and closely overlying a part of said head.

7. In a tonsillotome, a pair of crossed clamping members, a pin on which said members are fulcrurned, hemostat jaws on one pair of extremities of said members, handle parts at the opposite extremities of said members, a sleeve mounted on said pin, a slide received in said sleeve 'for motion longitudinally of the instrument, an apertured head on said slide normally overlying said hemostat jaws. and a cutting edge on the inner margin of the aperture of said head.

8. In a tonsillotome as claimed in claim '7, means for maintaining said cutting edge in sliding engagement with said jaws during motion of said head thereover.

9. In a tonsille-tome as claimed in claim 7, means for maintaining said cutting edge in sliding engagement with said jaws during motion of said head thereoverrcomprising a horn on each hemostat jaw extending rearwardly from the free extremity thereof and closely'overlying sub-V stantially half the periphery of said head.

VICTOR TROTTIER. 

